AccountId: 011433970860
ContactId: 07337c5e-d71c-4b32-852a-0eb65b62bb82
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372160 ms
Total Talk Time (AGENT): 175526 ms
Total Talk Time (CUSTOMER): 149291 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/07337c5e-d71c-4b32-852a-0eb65b62bb82_20250613T15:31_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEGATIVE] Yes, um, I am trying to get hearing aids through United Healthcare Hearing, and they say they are not contracted with you and cannot, uh, balance bill or whatever else, uh, I don't know the actual terminology, but they can't bill you for my deductible.
[CUSTOMER][POSITIVE] And I just wanna make sure that this is uh that I if I go ahead and pay it, I'll get reimbursed for it.
[AGENT][NEUTRAL] I can check and see if I say payable benefit under your policy. Um, may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and may I have a callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Do you have the policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] I do. It is 02, uh, I didn't put my glasses back on, hold on.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 025
[CUSTOMER][NEUTRAL] 83473
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] For security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII]. I'm not sure which mailing address you have. I have a, uh, permanent address and I have a summer address. Uh, the summer address is [PII], and the permanent address is [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. Yes.
[CUSTOMER][NEUTRAL] Uh uh [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] That's the one we have. OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and may I have that email address for verification?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, Mr. [PII]. OK.
[AGENT][NEUTRAL] Uh, let me go here to benefit first. And you said that uh you're with UnitedHealthcare and are, are they gonna um approve and pay or they're just gonna deny the claim or they're just saying they don't know how to apply it towards the deductible?
[CUSTOMER][NEGATIVE] They don't know how to apply it towards the deductible.
[CUSTOMER][NEUTRAL] They say that they don't have that they are not contracted with APL.
[CUSTOMER][NEGATIVE] So they can't file it for me, which from everything I've heard from you guys is anybody can file it for me.
[AGENT][NEUTRAL] The provider or the place of service and not the insurance. The insurance doesn't fall, yeah. OK. So basically, um,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] For what I see here, and this is not a guarantee of payment, just a verification of coverage. You do have a DME benefits which um a hearing aid is is based off DME um which is doable medical equipment.
[AGENT][NEUTRAL] No, it has to be um processed and applied towards the deductible in order for us to process the claim.
[AGENT][NEUTRAL] So if uh the provider of service cannot send in the claim because um they don't do secondary insurance or anything like that, you can submit your own claim.
[CUSTOMER][MIXED] OK, but I have to pay for it first.
[AGENT][NEUTRAL] It's up to your discretion.
[CUSTOMER][NEGATIVE] And I have to come up with the $3200.
[AGENT][NEUTRAL] Yeah, if that's what they want you to do, then yes, and more than likely that's what you have to do or you can find another provider.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK. Thank you very much.
[AGENT][NEUTRAL] You're welcome. Is there anything else I can help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, if I can get all of the information and file it directly with you, can you then send them a approval and then I don't know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, when you say an approval, what do you mean?
[CUSTOMER][NEGATIVE] I, I don't know. Uh, it, it feels like I'm in this catch 22, where, uh, instead of getting a decent health plan, we got this with the APL as an additional insurance, but in order to use it, I have to lay out the money myself.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, that's not the case all the time. Um, if you are in a place where they, there's a lot of companies that they have a system where they can put a secondary insurance and there's some that they're not that updated, so they don't have a system to put a secondary insurance and that's when you have to come out of.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And pay and get a reimbursement, but that's not with all of them. That's why I said if, if you wanna find another provider that can do this for you, you can talk to your doctor and they can more than likely refer you to somebody else to another place that may take both of them like United and us.
[CUSTOMER][NEUTRAL] OK. Do you know of a hearing aid?
[CUSTOMER][NEUTRAL] Company that does bill you.
[AGENT][NEUTRAL] It, it cannot be through us. We're just a secondary. United Healthcare is your primary, so it has to be in network with your primary.
[CUSTOMER][NEUTRAL] I know that.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] OK, um, so I have to check what who's in network with them first and then come to you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you have to check and see who's in network with United and then you need to let them know that you have a secondary insurance to see if they will follow your secondary insurance if they have that capability.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] [PII]o you have any other questions for me or any other concerns, Mr. [PII]?
[CUSTOMER][NEUTRAL] Nope.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] No, ma'am. Thank you for your clarification.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Right